What is Morton’s Neuroma?
A Morton’s neuroma is a thickening of the tissue that surrounds the small sensory nerve leading to the toes. The nerve passes under a ligament which connects the metatarsal bones in the forefoot. This can cause pressure on the nerve.
Morton’s neuroma most frequently develops between the 2nd & 3rd or the 3rd & 4th toes . Causes may include trauma, or excessive pressure on the front of the foot, and is more common in women.
Symptoms include; the sensation of walking on a pebble, and a burning pain in the ball of the foot which may radiate into the toes. There may also be numbness or a “clicking” feeling in the toes.
Treatment options range from non-operative to operative.
NON-OPERATIVE MANAGEMENT
Changes in footwear
Avoid high heels or tight shoes. Wear wider shoes with lower heels and a soft sole. This helps to decrease compression of the nerve.
Orthotics
Custom shoe inserts and pads may help relieve irritation by lifting and separating the bones, reducing the pressure on the nerve.
An initial Vasyli orthotic can be fitted at MOG, however a custom made orthotic by a Podiatrist may be required.
Injection
An injection of a corticosteroid will reduce the swelling and inflammation of the nerve, which should provide relief.
OPERATIVE MANAGEMENT
Conservative treatment may not completely relieve symptoms, or the condition may return after a period of conservative therapy. Surgery involves removing a small portion of the nerve ‘neurectomy’ and releasing the transverse ligament to relieve tension on the nerve. The surgery is usually a same-day discharge procedure. Walking is allowed, with a 2 week resting period.